January 25, 2017

Trump's HHS pick's final confirmation hearing: What Price said—and what comes next

Daily Briefing

The Senate Finance Committee on Tuesday held a confirmation hearing on Rep. Tom Price's (R-Ga.) nomination for HHS Secretary.

This was the Senate's second hearing on Price's nomination. Last week, Price—a House lawmaker and former orthopedic surgeon—fielded questions from the Senate Health, Education, Labor, and Pensions (HELP) committee on several issues, including the CMS Innovation Center and the GOP's plans to repeal the Affordable Care Act (ACA).

The Senate Finance Committee will vote on whether to advance Price's nomination to the full Senate, while the Senate HELP committee will not hold such a vote.

See the next steps on Price's nomination

Details of the latest hearing

Comments on CMMI

Lawmakers on the Senate Finance Committee asked Price about CMS' Center for Medicare and Medicaid Innovation (CMMI), about which Price has raised concerns in the past.

In response, Price said he is "a strong supporter of innovation" but felt that CMMI "has gotten off track a bit" by "mandatorily dictating to physicians how they must practice." He said he hopes "that we can move CMMI in a direction that actually makes sense for patients" and that the center could be a tool for improving certain health care programs.

Comments on the ACA

While President Trump has said his plan to replace the ACA would include "insurance for everybody," Price in the hearing said Republicans would propose a plan that would emphasize having the "option" or "opportunity" to access affordable health coverage.

Price said a replacement plan would "not abandon" individuals with pre-existing medical conditions and expressed his support for high-risk pools as one way to ensure individuals with pre-existing conditions have access to coverage. "Nobody ought to lose insurance because they got a bad diagnosis," he said.

Sen. Debbie Stabenow (D-Mich.) remarked to Price that high-risk pools in the past did not "produce good results."

According to USA Today, Price "skirted questions" about whether he would elect to not enforce the ACA's individual mandate in light of Trump's recent executive order directing federal agencies to "ease the burden" of the health law.

How to interpret Trump's ACA executive order

Price also declined to promise that no U.S. residents would lose coverage under ACA repeal, and instead said he would work with Congress to "make certain that we have the highest-quality health care and that every single American has access to affordable coverage."

Comments on Medicare, Medicaid

Lawmakers on the panel also asked Price about plans to reform Medicare and Medicaid.

Price said he no longer supports proposals to privatize Medicare, but that he would work to "save and strengthen" the program. "I would just convey to the Medicare population of this nation, they don't have reason to be concerned," he said, adding, "We look forward to assisting them in getting the care and coverage that they need."

When asked by Sen. Bob Menendez (D-N.J.) about whether the GOP's proposal to convert Medicaid into a block grant program would reduce program eligibility, Price said, "I think it would be determined by how that was set up."

Comments on vaccine safety

Price also faced questions about vaccine safety during the hearing.

Price said he accepts scientific evidence that vaccines do not cause autism. He also stated, "I think that science and health care has identified a very important aspect of public health, and that is the role of vaccination."

Comments on health IT

In addition, Sen. Pat Roberts (R-Kan.) asked Price if he will take action to reduce financial and regulatory burdens on critical access and rural hospitals.

Price said many health care providers in Georgia have left practice because of burdensome regulations, such as those implemented under the meaningful use program.

However, Price also touted the role health IT can play in helping to bolster care at critical access and rural hospitals. He said, "I think there are areas from a technological standpoint where we are missing the boat, especially for our rural areas and critical access hospitals." He added, "In health care, we put roadblocks up to the expansion of technology, especially in rural areas. We ought to be incentivizing that so that patients are able to receive the highest-quality care."

Comments on Price's stocks

Price also fielded ethics questions about allegations that he traded stock in dozens of companies while supporting legislation that could affect those companies.

Lawmakers pointed to a recent allegation that Price under-reported to the committee and the Office of Government Ethics the value of shares he holds in Innate Immunotherapeutics.

Price attributed the under­reporting to "a clerical error" and a misunderstanding. "The reality is that everything that I did was ethical, above­board, legal and transparent," Price said.

According to the Washington Times, Republicans on the committee throughout the hearing defended Price's ethics and said he has the "experience and qualifications" necessary to run HHS.

Committee Chair Orrin Hatch (R-Utah), who expressed his support for Price, accused Democrats of "grossly exaggerated and distorted attacks on [Price's] views and his ethics."

Meanwhile, Sen. Ron Wyden (D-Ore.) said "it is hard to see" Price's private investments "as anything but a conflict of interest and an abuse of position."

Next steps

Next, the Senate Finance Committee will vote on whether it will recommend Price's confirmation to the full Senate. The committee must vote to either:

  • Report the nomination favorably to the full Senate;
  • Report the nomination unfavorably to the full Senate; or
  • Report the nomination without recommendation to the full Senate.

According to the New York Times, the panel could vote on Price's nomination next week. Republicans on the panel, which hold the majority, likely would support Price's nomination, the New York Times reports.

However, if the committee takes too long to vote on the nomination, the full Senate can vote to invoke cloture, which allows the full chamber to consider the nomination.

Fifty-one votes in the full Senate are needed to confirm Price's nomination. Republicans hold 52 seats in the Senate, while Democrats hold 46. Two Senators identify as Independent but caucus with Democrats. In the instance of a tie, Vice President Pence would cast his vote as a tie breaker.

(Goldstein/Eilperin, Washington Post, 1/24; Pradhan et al., Politico, 1/24; MacDonald, FierceHealthcare, 1/24; Small, FierceHealthcare, 1/24; Muchmore, Modern Healthcare, 1/24; Clarke/Cornwell, Reuters, 1/24; Morse, Healthcare Finance, 1/24; Versel, MedCity News, 1/24; Howell, Washington Times, 1/24; Fram/Alonso-Zaldivar, AP/Sacramento Bee, 1/24; Firth, MedPage Today, 1/24; O'Donnell, USA Today, 1/24; Sullivan/Hellmann, The Hill, 1/24; Pear/Kaplan, New York Times, 1/24; Parks/Rogin, ABC News, 1/10; Senate.gov, accessed 1/25; Lee/Lunby, CNN, 1/24).

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